Clinical Assessment of Child and Adolescent Personality and ...

428 chapter 18 Assessment of Depression and anxietydisorders have often not been developedwith potential developmental influenceson the manifestation of anxiety in mind(Silverman & Ollendick, 2005).l While anxiety often is apparent in casesof depression, anxiety disorders alsooften occur in the absence of depression(Silverman, 1993). Anxiety with comorbidproblems is associated with pooreroutcomes than anxiety alone (see Saavedra& Silverman, 2002).l Separation Anxiety Disorder typicallyoccurs in children less than 11–13 yearsof age (Strauss, 1993; Weems, Hammond-Laurence,Silverman, & Ginsburg,1998); however, social phobiabecomes more common in adolescence(Weems et al., 1998).l Fears of animals, the darkness, andheights are more likely to occur atyounger ages than social phobias which,in turn, occur at younger ages than agoraphobia(Strauss, 1993).l There are two main types of school phobia:those that come on acutely in a childwho has functioned reasonably normallybefore onset, and those that arise in achild who has had similar problems fromthe preschool years and has never developedthe social skills that would permitnormal functioning (Berg, 1993).l The average of onset for childhoodObsessive-Compulsive Disorder (OCD)is approximately 9–12 years, with familyhistory of OCD placing a youngster atriskfor an even younger onset of OCDsymptoms (see Baldwin and Dadds,2008 for review).l The central symptoms of PosttraumaticStress Disorder (PTSD),increased arousal, psychic numbing,and re-experiencing the trauma, occurin children as well as adults who arediagnosed with the condition (Last,1993). However, the frequency andintensity of these symptoms may beimportant indicators of impairmentdue to PTSD symptoms for children(Carrion, Weems, Ray, & Reiss, 2002).Specialized Measures of AnxietyRating ScalesRevised Children’s ManifestAnxiety Scale (RCMAS; Reynolds &Richmond, 1985)The Revised Children’s Manifest AnxietyScale (RCMAS; Reynolds & Richmond)measures the expression of anxiety symptomatologywhether or not the constructis conceptualized as being a state or a trait.We review the RCMAS in relative depthbecause it is widely used and has manyunique features for a single constructrating scaleScale ContentThe RCMAS includes 37 items distributedamong four scales: PhysiologicalAnxiety (10 items), Worry/Oversensitivity (11 items), Social concerns/Concentration(7 items), and Lie(L, 9 items). The content of the subscalesappears diverse. Items from the physiologicalanxiety subscale, for example, rangefrom “difficulty making decisions” (notethat the physiological nature of this itemis not apparent) to “awakening scared fromsleep” to “having sweaty hands.”The L scale is a rather unique featureof a single-construct measure. TheRCMAS L scale measures children’s tendencyto portray themselves in a favorablelight with items like, “I always have goodmanners.” To obtain a high score on thisscale, children would have to deny evergetting angry and liking everyone theyknow. This scale is likely to be transparentto many adolescents. Research has shownthat younger children tend to score higheron the RCMAS Lie scale than older youth(Pina, Silverman, Saavedra, & Weems,2001).